Carroll, William David

Carroll, William David is an individual health care provider with primary practice located at 3536 Mendocino Ave 300, Santa Rosa CA 95403-3634. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Carroll, William David can be contacted via phone (707) 546-2180.

Contact Information

Primary practice address
3536 Mendocino Ave 300 Santa Rosa CA 95403-3634
Phone: (707) 546-2180
Fax: (707) 546-2188
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X A39947 California
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X A39947 California

Profile Details

NPI number 1922005891
LBN Legal business name Carroll, William David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2005
Last updated Feb 7th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922005891 NPPES
California Other 00A399470 BLUE SHIELD OF CALIFORNIA
California MEDICAID 00A399470 BLUE SHIELD OF CALIFORNIA
California Other 110105821 BLUE SHIELD OF CALIFORNIA

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